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EVIDENCE-BASED MEDICINE: OBVIOUS BENEFITS AND HIDDEN DRAWBACKS

Keywords: drug evaluation, evidence-based medicine, clinical trials, clinical experience

Abstract

The article covers basic information on the comparative evaluation of drugs efficacy and safety from the standpoint of both clinical experience and evidence-based medicine. It is emphasized that despite all its advantages evidencebased medicine does not contradict the "opinion-based medicine". There have been presented the basic rules for conducting randomized clinical trials referred to as the most modern method of evidence collection. The main criteria of evidence are described. At the same time, it is emphasized that evidence-based medicine has its drawbacks. The main of them - is inability to transfer the results obtained in a clinical trial to the treatment of all patients with the disease in question. The principle of comparing results between clinical trial and real-world data (RWD / RWE) is described – the project RCT DUPLICATE. The author’s opinion on the main drawbacks in conducting and reporting clinical trials is presented. A number of ethical issues in clinical trials is evaluated. The author claims that the selection of optimal treatment strategy for a particular patient should rely on combination of evidence-based medicine, clinical experience, and historical data as well.

References

Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71-2. https://doi.org/10.1136/bmj.312.7023.71.

Grinhalh T. Osnovy dokazatelnoj mediciny [CD-ROM]. Moskva: GJeOTARMEDia, 2006. 240 p. 1 CD-ROM: text elect. (Russian).

Towards better patient care: drugs to avoid in 2022 [Internet]. Prescrire Int. 2022;31(234):50. Available from: https://clck.ru/34NUR3.

Lieber CS, Weiss DG, Groszmann R, Paronetto F, Schenker S. I. Veterans Affairs Cooperative Study of polyenylphosphatidylcholine in alcoholic liver disease: effects on drinking behavior by nurse/physician teams. Alcohol Clin Exp Res. 2003;27(11):1757-64. https://doi.org/10.1097/01.ALC.0000093744.12232.34.

European Stroke Organisation (ESO) Executive Committee. ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25(5):457-507. https://doi.org/10.1159/000131083.

Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL; American Heart Association Stroke Council. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-e110. https://doi.org/10.1161/STR.0000000000000158.

Masoudi FA, Havranek EP, Wolfe P, Gross CP, Rathore SS, Steiner JF, Ordin DL, Krumholz HM. Most hospitalized older persons do not meet the enrollment criteria for clinical trials in heart failure. Am Heart J. 2003;146(2):250-7. https://doi.org/10.1016/S0002-8703(03)00189-3.

Franklin JM, Patorno E, Desai RJ, Glynn RJ, Martin D, Quinto K, Pawar A, Bessette LG, Lee H, Garry EM, Gautam N, Schneeweiss S. Emulating Randomized Clinical Trials With Nonrandomized Real-World Evidence Studies: First Results From the RCT DUPLICATE Initiative. Circulation. 2021;143(10):1002-1013. https://doi.org/10.1161/CIRCULATIONAHA.120.051718.

Laurence JP, Raymond H. Princip Pitera, ili Pochemu dela idut vkriv’ i vkos [The Peter Principle: Why Things Always Go Wrong]. Minsk: Popurri; 2003. 256 p.

Komajda M, Tavazzi L, Francq BG, Böhm M, Borer JS, Ford I, Swedberg K; SHIFT Investigators. Efficacy and safety of ivabradine in patients with chronic systolic heart failure and diabetes: an analysis from the SHIFT trial. Eur J Heart Fail. 2015;17(12):1294-301. https://doi.org/10.1002/ejhf.347.

Ambrosioni E, Safar M, Degaute JP, Malin PL, MacMahon M, Pujol DR, de Cordoüe A, Guez D. Lowdose antihypertensive therapy with 1.5 mg sustainedrelease indapamide: results of randomised double-blind controlled studies. European study group. J Hypertens. 1998;16(11):1677-84. https://doi.org/10.1097/00004872-199816110-00015.

Jakusevich VV. Ob etike nauchnyh publikacij. Rational pharmacotherapy in cardiology. 2014;10(5):572. (Russian). edn: SXKLWZ.

Published
2023-06-13
How to Cite
1.
Yakusevich VV. EVIDENCE-BASED MEDICINE: OBVIOUS BENEFITS AND HIDDEN DRAWBACKS. journalHandG [Internet]. 2023Jun.13 [cited 2024Nov.21];7(1):6-14. Available from: http://hepatogastro.grsmu.by/index.php/journalHandG/article/view/295
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